Signs of Kratom Addiction: 10 Symptoms to Know

Q: Is kratom really addictive?

Yes. Kratom's active alkaloids — mitragynine and 7-hydroxymitragynine — are partial agonists at mu-opioid receptors, the same receptors targeted by heroin, oxycodone, and morphine. With regular use, opioid-type physical dependence develops: tolerance builds, and stopping causes withdrawal symptoms including muscle aches, nausea, insomnia, anxiety, and cravings. Kratom withdrawal mirrors opioid withdrawal in its symptoms and mechanism. Many people who started kratom to quit opioids find themselves dependent on kratom instead.

Q: What are the behavioral signs of kratom addiction?

Behavioral signs of kratom addiction include using kratom multiple times daily to avoid withdrawal rather than for its original purpose, planning activities around access to kratom, spending significant money on kratom products, hiding use from family and physicians, using kratom to manage any discomfort or stress rather than just specific symptoms, and continuing to use despite recognizing negative health or financial consequences. People with kratom addiction often rationalize it by pointing to its natural origin or legal status.

Q: How is kratom addiction treated?

Treatment approaches include gradual kratom tapering, buprenorphine (Suboxone) off-label — case reports and small studies support its use for kratom dependence given kratom's opioid receptor activity — clonidine for autonomic withdrawal symptoms, and symptomatic support medications. Kratom crosses over with opioid use disorder treatment protocols because of its mechanism. Standard addiction counseling and recovery support apply. Call SAMHSA (1-800-662-4357) to find addiction medicine specialists familiar with kratom dependence.

Why Kratom Is Addictive

Kratom (Mitragyna speciosa) is a Southeast Asian plant increasingly sold in the United States as a dietary supplement, pain reliever, and self-treatment for opioid withdrawal. Its two primary alkaloids — mitragynine and 7-hydroxymitragynine — are partial agonists at mu-opioid receptors, the same receptors activated by heroin, oxycodone, and morphine.

At low doses, kratom produces stimulant effects. At higher doses, the opioid effects dominate: pain relief, sedation, and euphoria. With regular use, opioid-type tolerance and physical dependence develop. The "natural" and legal status of kratom leads many users to underestimate its dependence potential — often until they try to stop.

10 Signs of Kratom Addiction

Sign 1

Using to avoid withdrawal

Dosing multiple times daily not for the original purpose (pain, energy, mood) but to prevent muscle aches, nausea, and anxiety that appear when doses are missed

Sign 2

Tolerance

Needing progressively higher doses or more frequent dosing to achieve the same effects — a hallmark of opioid-receptor-mediated dependence

Sign 3

Planning around kratom

Scheduling activities, travel, and daily routines around access to kratom — being unable to go several hours without anxiety about running out

Sign 4

Significant financial spending

Spending hundreds of dollars monthly on kratom powder, capsules, or extracts — with use taking financial priority over other needs

Sign 5

Hiding use

Concealing kratom use from family members, employers, and especially physicians — rationalizing secrecy by pointing to kratom's legal status

Sign 6

Opioid-like withdrawal symptoms

Muscle aches, nausea, hot/cold sweats, insomnia, anxiety, irritability, and restless legs when doses are late or missed — mirroring opioid withdrawal

Sign 7

Using for all discomfort

Reaching for kratom for any physical or emotional discomfort — headaches, stress, low mood, social anxiety — not just the original condition it was used for

Sign 8

Failed quit attempts

Multiple sincere attempts to stop or dramatically cut back, followed by return to use due to withdrawal symptoms or overwhelming cravings

Sign 9

Escalating dose forms

Progressing from powder to capsules to concentrated extracts or "enhanced" kratom products — seeking stronger and faster effects

Sign 10

Denial despite consequences

Dismissing concerns from family or physicians, rationalizing continued use with "it's natural" or "it's legal" despite observable health, financial, or relationship consequences

The Kratom-to-Opioid Pipeline (and Back)

A significant subset of people with kratom use disorder began using kratom specifically to get off opioids. Kratom activates many of the same receptors and initially provides relief from opioid cravings and withdrawal. However, because kratom itself activates opioid receptors, regular users develop their own dependence — trading one opioid-receptor-mediated addiction for another.

This pattern — starting kratom for opioid recovery and developing kratom dependence — is clinically recognized. It is important to address compassionately rather than dismissively.

Treatment Options

Gradual taper

Slowly reducing dose over weeks to months is the gentlest approach and avoids severe withdrawal. Because kratom is unregulated and dose varies by product, working with an addiction medicine physician to standardize dose is ideal before tapering.

Buprenorphine (off-label)

Given kratom's opioid receptor activity, buprenorphine (Suboxone) is increasingly used off-label for kratom dependence. Case reports and small studies support its effectiveness at managing withdrawal and cravings. Requires a waivered prescriber.

Clonidine

Clonidine addresses autonomic withdrawal symptoms (sweating, anxiety, elevated heart rate) and is commonly used in opioid withdrawal management — applicable to kratom withdrawal by the same mechanism.

Symptomatic support

Loperamide for GI symptoms, antiemetics for nausea, sleep aids for insomnia, and NSAIDs for muscle pain can help bridge through the acute withdrawal phase.

Frequently Asked Questions

Is kratom really addictive?

Yes. Kratom's alkaloids (mitragynine and 7-hydroxymitragynine) are partial mu-opioid agonists. Regular use produces opioid-type physical dependence with tolerance and withdrawal. Many people who started kratom to manage opioid withdrawal develop kratom dependence.

What are the behavioral signs of kratom addiction?

Using multiple times daily to avoid withdrawal, planning life around access to kratom, hiding use, spending heavily on kratom, and rationalizing continued use despite consequences.

How is kratom addiction treated?

Gradual tapering, buprenorphine off-label (given opioid receptor overlap), clonidine for withdrawal symptoms, and symptomatic support. Call SAMHSA (1-800-662-4357) for treatment referrals including addiction medicine specialists familiar with kratom.

Sources

Boyer EW et al. Self-treatment of opioid withdrawal using kratom (Mitragynia speciosa korth). Addiction. 2008;103(6):1048–1050. PMID: 18399647
Singh D et al. Kratom (Mitragyna speciosa korth) dependence, withdrawal symptoms and craving in regular users. Drug Alcohol Depend. 2014;139:132–137. PMID: 24793623
Weiss ST et al. Buprenorphine treatment of kratom use disorder: A systematic review. J Addict Med. 2022;16(5):e342–e347. PMID: 34723855
Prozialeck WC et al. Pharmacology of kratom. J Am Osteopath Assoc. 2012;112(12):792–799. PMID: 23212430